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World J Gastroenterol. May 28, 2006; 12(20): 3259-3264
Published online May 28, 2006. doi: 10.3748/wjg.v12.i20.3259
Ethical tensions in solid organ transplantation: The price of success
Sanjay Kulkarni, David C Cronin II
Sanjay Kulkarni, Department of Surgery, Yale University School of Medicine, Tompkins 202, 333 Cedar Street, New Haven, CT 06520, United States
David C Cronin II, Director, Liver Transplantation, Director Transplant Intensive Care Unit, Yale-New Haven Hospital, Greenwall Faculty Scholar, Yale University School of Medicine, Tompkins 202, 333 Cedar Street, New Haven, CT 06520, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Sanjay Kulkarni, MD, Assistant Professor of Surgery, Yale University School of Medicine, Tompkins 202, 333 Cedar Street, New Haven, CT 06520, United States. sanjay.kulkarni@yale.edu
Telephone: +1-203-7852565 Fax: +1-203-7857162
Received: March 29, 2006
Revised: April 6, 2006
Accepted: April 16, 2006
Published online: May 28, 2006
Abstract

Solid organ transplantation has rapidly developed into the therapy a choice for end-stage organ failure. The expansion of its use has resulted is a large deficiency in organ supply. To address this, the field of organ transplantation has attempted to develop new strategies that would increase the availability of organs for transplant. Some of these strategies include expansion of the donor pool by increasing the number of living donors or using deceased donor organs that may be marginal or “expanded”. The intent is to bring life-saving therapy to individuals in need; however, much of this expansion has been brought forward without clear prospective guidelines. This article focuses on the current disparity between organ supply and demand, and how this has impacted the use of living donors and development of the “expanded donor” concept.

Keywords: Ethical tensions; Organ transplantation; Donor